The Impact of Sleep Deprivation on Orthopaedic Surgeons: A Systematic Review

Sleep deprivation is known to impact cognition, health and mood. Although the effect of sleep deprivation among medical and certain surgical specialties has been explored, there is a paucity of literature regarding sleep in orthopaedic surgeons. This systematic review attempts to provide a comprehensive overview of the current state of research on sleep in orthopaedic surgeons. Following the PRISMA guidelines for systematic reviews, we conducted a search of MEDLINE, Psychinfo and EMBASE to find all articles about sleep in orthopaedic surgeons. Inclusion criteria were non-review articles discussing sleep in orthopaedic surgery, English text, enrollment of attending or resident or fellow orthopaedic surgeons, reporting of sleep-related variables and publishing in a peer-reviewed journal. Out of 539 studies generated from our search, 10 were included in this review. The resulting study population included 232 residents, 10 fellows and 560 attendings. Average sleep was reported in nine articles; however, only two articles used objective measurements of sleep. Other reported outcomes varied widely, which included cognitive tests, reaction time, burnout/mood, self-reported sleepiness and arthroscopic skill. No articles reported on race, biochemical assays, call schedule, exercise, or utilised any intervention to improve sleep. Our systematic review concludes that not only is there a lack of research on sleep in orthopaedic surgeons, but that future research should include objective sleep measurements, including a greater breadth of outcome measures and potential interventions. Such studies will specifically target improvements in physician mental health and overall well-being, as well as promote durable patient safety.